Organization
ACT 3 CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON PACE (OFFICE MANAGER)
(334) 291-8360
Entity
Organization
Contact information
Practice address
7309 TRIER RD, FORT WAYNE, IN 46815-5566
(260) 515-3275
Mailing address
7309 TRIER RD, FORT WAYNE, IN 46815-5566
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
02/10/2014
Last updated
07/18/2023
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